The Way You Are Predicts the Kind of Therapy You Need

The Way You Are Predicts the Kind of Therapy You Need
Gorka Jiménez Pajares

Written and verified by the psychologist Gorka Jiménez Pajares.

Last update: 23 January, 2023

Why do we improve in psychotherapy? Different disciplines, such as psychiatry or psychology, have tried to answer this question. Today, it’s known that certain characteristics of the client influence the success of psychological treatments. For instance, is spirituality important to them? What’s their coping style like? Are they willing to be ‘active’ in the therapeutic process? With this in mind, we can confidently state that the way you are predicts the kind of therapy you require.

According to Lambert (2019), up to 33 percent of the total therapeutic change of people who attend psychotherapy is due to extra-therapeutic factors. These factors include those associated with the client/patient and their vital history. This is completely understandable when you take into account that it’s the client who initiates the change process.

“If the client doesn’t absorb, use, and follow through with the therapist’s facilitation efforts, then nothing happens.”

-Bergin-

patient in therapy

Characteristics of the therapist

There’s a wide range of heterogeneous characteristics that have been proposed in respect of whether a client selects one type of therapy or another. We’re going to focus on some of them.

Firstly, in order to carry out a good therapeutic process, it’s necessary to include the client’s characteristics, perceptions, and preferences, with the aim of personalizing the therapy as much as possible.

“As therapists have become more accommodating to the client’s resources, more changes seem to be taking place.”

-Bergin-

1. Level of functionality

A minimal level of functionality has been identified as a factor that complicates the prognosis of psychotherapy. Aspects, such as the depth of the limitations imposed by the clinical condition are related to a worse prognosis, and vice versa.

However, the opposite occurs in the child population. In fact, when the severity of behavior problems is greater, the effectiveness of parental training programs is also higher.

With regard to adults, it’s easy to deduce that, if an individual’s life is more compromised, they need more therapy sessions. On the other hand, when the premorbid level of functioning is really low, directive therapies aimed at increasing it are highly beneficial. Among these, is intervention through behavioral activation.

2. Preferences

Preferences refer to the activities and psychotherapy conditions with which the client feels most comfortable. There are various instruments, such as the C-NIP ( The Cooper-Norcross Inventory of Preferences) that facilitate the evaluation of the client’s preferences. It suggests that, when choosing a psychotherapist, the following aspects should be considered:

  • Activity preferences. These are the tasks to be carried out throughout the treatment, the objectives the client wants to achieve, and the number, duration, and frequency of sessions they’d like to have. They should agree on these preferences with their chosen therapist.
  • Psychotherapist preferences. Clients usually feel more comfortable seeing a therapist of a certain gender. This is completely normal. The degree of directivity is also important. It refers to the specific script that the therapy follows. For example, cognitive-behavioral therapy is generally extremely directive. That’s because the sessions are more prepared and the therapist exerts more influence. Moreover, there’ll be more ‘homework’ between sessions. On the contrary, psychoanalysis isn’t particularly directive.

Certain client preferences can be detrimental. If so, the therapist will advise them on the best modality of intervention.

“For example, a client with social phobia might prefer to attend individual treatment sessions, even though group treatment would be more effective for their problem.”

-Fonseca-

3. Spirituality and religiosity

Scientific literature supports the relationship between spirituality /religiosity and physical and mental health. Among other things, it provides a sense of belonging, connection, and support. The client might choose to propose certain ‘adaptations’. Indeed, if religiosity and spirituality represent a core aspect of their identity, the therapist can take this fact into account.

It’s been proven that, when treatments accommodate specific characteristics of the client, the results are as effective as the ‘lay’ approaches.

“When treatment is tailored to clients’ religious and spiritual preferences, clients appear to benefit more from treatment.”

-Castonguay-

man in psychotherapy

4. Coping style

For Beutler, coping style is a personality trait. It drives the individual to behave in a certain way in order to adapt to changing and uncontrollable environments and reduce the discomfort they might be experiencing. There are two kinds of coping styles; internalizing and externalizing.

Those with an externalizing coping style are impulsive and sociable and show a marked tendency to delegate their responsibilities to others. This style has been linked to substance use and antisocial personality disorder.

On the other hand, those with an internalizing coping style have low impulsivity, a tendency to ruminate, and a high need for control. This coping style has been linked to generalized anxiety disorder, OCD, depression, or social anxiety.

  • If your coping style is of the externalizing type, you’ll probably tend to try and ‘avoid’ or ‘escape’ from stressful situations. In fact, if you do find yourself having to face them, you may blame others or your environment for your discomfort.
  • If your coping style is of the internalizing type, you tend to deal with any changes and threats. If you fail, you may blame yourself.

Clients with externalizing coping styles benefit more from behavior modification therapies focused on symptom reduction. Among these are training in emotional regulation skills, problem-solving, and self-control training.

Conversely, clients with internalizing coping styles may benefit more from therapies that seek to promote insight or self-awareness. In fact, the most beneficial intervention in these cases is the one that promotes understanding, self-reflection, comprehension, and interpersonal bonding. If you have an internalizing coping style, you should look for a therapy that focuses on cognitive change and emotional expression. For instance, cognitive therapy or REBT.

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  • Pedrero, F. E. (2020). Manual de Tratamientos Psicológicos. Infancia y Adolescencia. Pirámide.
  • Muela Aparicio, A., & Sansinenea Méndez, E. (2020). Tratamientos psicológicos personalizados: orientaciones clínicas. Papeles del psicólogo, 41(1), 16-26.
  • Längle, A. (2008). La espiritualidad en psicoterapia: entre la inmanencia y trascendencia en el Análisis Existencial.

The contents of Exploring Your Mind are for informational and educational purposes only. They don't replace the diagnosis, advice, or treatment of a professional. In the case of any doubt, it's best to consult a trusted specialist.